1. JAUNDICE Prepared by: ALIA ZULAIKHA MOHD HANIF D11B037 AHMAD SALLEHUDDIN MUKHTARRUDDIN D11A001 ABDUL MUHAIMIN ABD WAHAB D11A007 AHMAD HANIF B. M AMIN D11B043

2. Introduction and normal condition of jaundice By: Alia Zulaikha Mohd Hanif D11 B037

3. INTRODUCTION Jaundice is not a dz by its own but reflects some other underlying dz Jaundice (also known as icterus ) is a yellowish pigmentation of the skin, the conjunctival membranes over the sclerae, other mucous membrane caused by hyperbilirubinemia Often seen in liver dz such as hepatitis or liver cancer indicate obstruction of the biliary tract, for example by gallstones or pancreatic cancer, or less commonly be congenital in origin.

4. Darkening of urine due to excess breakdown of rbc Jaundice of gums Jaundice of the sclera of the eye *concentration higher than 1.8 mg/dL (>30µmol/L) leads to jaundice

5. NORMAL CONDITION The average life span of a normal eryhtrocytes I20 days. The red cells are destroyed, and the hemoglobin is broken down. Hemoglobin, the part of red blood cells that carries oxygen, is broken down into a dark greenish yellow pigment called bilirubin Bilirubin is then carried in the bloodstream to liver and is excreted into intestine as a component of bile

6. If bilirubin cannot be excreted into bile quickly enough, it builds up in the blood. Excess bilirubin is deposited in the skin, resulting in the yellowish discoloration called jaundice.

8. Causes and symptoms of jaundice By: Abdul Muhaimin bin Abd Wahab D11 A007

9. CAUSES Pre-hepatic icterus – Too much bilirubin being produced and liver is unable to process all of it. (Overproduction) – Due to excessive breakdown of RBCs (Anemia) Primary hepatic jaundice – Abnormal metabolism and excretion of bilirubin by liver cells. (Failure hepatocyte uptake and failure to excrete) – Liver disease that may contribute to other diseases. Diabetes mellitus, cancer, acute toxic hepatitis, cholangiohepatitis, cirrhosis of liver and fatty liver syndrome.

10. CAUSES Post-hepatic icterus – When the bile duct interferes with excretion of bilirubin. – Causes bile duct obstruction, a rupturing bile duct, pancreatic disease, cancer, inflammation of gallbladder and bile duct. – Causing gallstone or tumor. (Blockage duct carrying bile from liver to small intestine)

11. SYMPTOMS Yellow Colouring – Primary symptom of jaundice. – In the whites of the eyes, in the skin at base of ears, along the gums and in the skin of abdomen. Lethargy – Becomes lethargy, lose appetite and weight loss. – Looks emaciated and losing muscular body due to body begins to feed off the muscles. Digestive Problems – Vomiting, diarrhea and stomach bloating. – Frequently urinate due to obsessively drink. – Serious condition: Poisoning, heartworm disease, liver infections and cirrhosis, pancreatic, gall bladder and intestinal disease.

12. General Symptoms Skin and whites of eyes appear yellow Urine dark (because of excessive bilirubin excreted through the kidney) Itching Vomiting Diarrhea Lethargy Excessive thirst Loss of appetite Difficulty in breathing Abdominal distension Excessive drinking and urinating

14. Diagnosis and treatment of jaundice By: Ahmad Hanif bin M Amin D11B043

16. Diagnosis Physical examination – yellow discoloration of the skin or mucous membranes Bloodwork – serum bilirubin PCV – to rule out anemia Abdominal and chest X-rays – To assess organ size and shape & presence of foreign objects Abdominal ultrasound – To assess size, shape and structure of abdominal organs, especially liver – Bile duct obstruction

17. Treatment No 1 for all & No specific treatment !!! It is directed to underlying disorder Some liver diseases respond to specific treatments, while the majority can only be managed symptomatically and supportively. Treatment of liver disease (jaundice) may include: - fluid administration, electrolyte - antibiotics - antacids - non steroidal anti-inflammatory drugs (NSAIDs)- Carprofen Rimadyl, drugs to suppress scar tissue formation or to influence bile flow - vitamin K, vitamin E - fatty acid supplements

18. The end!!!